MercyOne Clinton Medical Center
1410 N. Fourth St, Clinton, IA · MercyOne · · NPI 1427093962
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $66.70 | $66.70 | $0.85 – $18.04 | 104 |
| ER Visit (level 1, minor) CPT 99281 | $273.00 | $420.00 | $5.86 – $1,453.00 | 118 |
| ER Visit (level 2) CPT 99282 | $646.75 | $583.00 | $25.77 – $583.00 | 783 |
| ER Visit (level 3) CPT 99283 | $1,092.55 | $931.00 | $44.30 – $931.00 | 783 |
| ER Visit (level 4) CPT 99284 | $2,785.31 | $1,558.00 | $9.09 – $1,558.00 | 783 |
| ER Visit (level 5, high severity) CPT 99285 | $4,744.80 | $2,881.00 | $9.09 – $2,133.00 | 118 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $908.50 | $908.50 | $35.49 – $125.40 | 104 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | $271.25 | $271.25 | $76.76 – $271.25 | 33 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $427.50 | $427.50 | $2.60 – $9.20 | 104 |
| Esophagosc dilate balloon 30 CPT 43214 | $13,856.60 | $705.00 | $0.96 – $7,978.49 | 769 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | $318.00 | $318.00 | $25.35 – $285.20 | 768 |
| Esoph egd dilation <30 mm CPT 43249 | $12,118.34 | $558.00 | $43.45 – $4,106.37 | 769 |
| Esrd home pt serv p mo 20+ CPT 90966 | $882.00 | $882.00 | $197.88 – $882.00 | 768 |
| Esrd serv 1 visit p mo 20+ CPT 90962 | $606.00 | $606.00 | $137.17 – $606.00 | 768 |
| Esrd srv 2-3 vsts p mo 20+ CPT 90961 | $883.00 | $883.00 | $198.09 – $883.00 | 768 |
| Esrd srv 4 visits p mo 20+ CPT 90960 | $1,063.00 | $1,063.00 | $237.55 – $1,063.00 | 768 |
| Established Patient Office Visit (level 1) CPT 99211 | $25.00 | $25.00 | $4.90 – $18.00 | 768 |
| Established Patient Office Visit (level 2) CPT 99212 | $76.00 | $76.00 | $8.04 – $76.00 | 768 |
| Established Patient Office Visit (level 3) CPT 99213 | $141.00 | $141.00 | $30.61 – $141.00 | 769 |
| Established Patient Office Visit (level 4) CPT 99214 | $209.00 | $209.00 | $49.07 – $209.00 | 769 |
| Established Patient Office Visit (level 5) CPT 99215 | $307.00 | $307.00 | $65.37 – $307.00 | 769 |
| Estradiol total CPT 82670 | $195.00 | $300.00 | $27.07 – $173.00 | 47 |
| Etonogestrel implant system HCPCS J7307 | $6,376.80 | $6,376.80 | $1,194.50 – $6,376.80 | 36 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $174.75 | $174.75 | $14.30 – $57.25 | 103 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $122.20 | $188.00 | $53.20 – $197.20 | 44 |
| Evaluation of speech fluency 92521 CPT 92521 | $186.55 | $287.00 | $81.22 – $287.00 | 47 |
| Evoked oa emissions ltd CPT 92587 | $276.25 | $425.00 | $120.28 – $462.07 | 118 |
| Exam of vagina w/scope 57420 CPT 57420 | $195.00 | $195.00 | $25.88 – $195.00 | 768 |
| Ex arm/elbow tum deep 5 cm/> CPT 24073 | $2,371.00 | $2,371.00 | $208.32 – $2,245.33 | 768 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | $16,005.99 | $744.00 | $2.28 – $3,534.34 | 769 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | $14,914.34 | $588.00 | $2.28 – $6,215.96 | 769 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $1,560.00 | $2,400.00 | $30.76 – $2,400.00 | 783 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $651.95 | $1,003.00 | $42.07 – $1,515.37 | 783 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $2,991.30 | $2,170.00 | $31.53 – $2,170.00 | 783 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $516.00 | $516.00 | $5.98 – $40.48 | 768 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $15,446.89 | $886.00 | $2.28 – $6,215.96 | 769 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $1,215.50 | $1,870.00 | $529.21 – $1,870.00 | 117 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $898.30 | $1,382.00 | $42.92 – $1,515.37 | 783 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | $17,391.40 | $914.00 | $65.31 – $3,534.34 | 769 |
| Exc forearm les sc 3 cm/> CPT 25071 | $14,994.78 | not published | $2.28 – $3,534.34 | 86 |
| Exc hand les sc < 1.5 cm CPT 26115 | $1,155.00 | $1,155.00 | $67.58 – $761.00 | 768 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | $15,281.17 | $2,382.00 | $2.28 – $6,215.96 | 769 |
| Excise inferior turbinate CPT 30130 | $2,700.00 | $2,700.00 | $104.51 – $1,350.00 | 768 |
| Excise lip or cheek fold CPT 40819 | $735.00 | $735.00 | $48.47 – $609.67 | 768 |
| Excise/repair mouth lesion CPT 40812 | $680.00 | $680.00 | $26.27 – $680.00 | 768 |
| Excise submaxillary gland CPT 42440 | $1,536.00 | $1,536.00 | $16.06 – $245.76 | 769 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $765.05 | $1,177.00 | $38.34 – $1,515.37 | 783 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $14,636.76 | $1,337.00 | $2.28 – $3,534.34 | 783 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $1,083.55 | $1,122.00 | $30.56 – $1,515.37 | 783 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $17,301.24 | $809.00 | $2.88 – $3,534.34 | 769 |
| Excision graft extremity CPT 35903 | $1,829.00 | $1,829.00 | $26.43 – $190.88 | 768 |
| Excision of tongue lesion CPT 41112 | $2,580.50 | $3,970.00 | $1,123.51 – $7,094.93 | 117 |
| Excision tongue lesion without closure 41110 CPT 41110 | $5,430.10 | $8,354.00 | $17.92 – $8,354.00 | 783 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | $15,258.32 | $1,600.00 | $20.29 – $3,534.34 | 769 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $17,642.26 | not published | $9.09 – $6,215.96 | 86 |
| Exc prtl bn phlnx toe CPT 28124 | $1,423.00 | $1,423.00 | $92.63 – $1,036.06 | 768 |
| Exc rect tum transanal full CPT 45172 | $3,002.00 | $3,002.00 | $35.43 – $289.44 | 768 |
| Exc shoulder tum deep < 5 cm CPT 23076 | $1,865.00 | $1,865.00 | $166.89 – $1,222.00 | 768 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | $16,263.65 | $1,526.00 | $2.88 – $6,215.96 | 769 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | $1,057.00 | $1,057.00 | $92.24 – $865.65 | 768 |
| Exc sq tumor/leg/ankle 3cm/> 27632 CPT 27632 | $17,479.64 | $2,814.00 | $2.28 – $6,215.96 | 769 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | $15,773.12 | $1,436.00 | $18.02 – $3,534.34 | 769 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | $1,103.00 | $1,103.00 | $7.75 – $116.32 | 768 |
| Exc thigh/knee tum dep 5cm/> CPT 27339 | $2,572.00 | $2,572.00 | $32.55 – $267.84 | 768 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $1,033.00 | $1,033.00 | $70.44 – $945.64 | 768 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | $2,420.11 | $3,723.25 | $0.02 – $0.12 | 40 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $2,952.42 | $4,542.19 | $7.08 – $25.00 | 33 |
| Explore/treat ankle joint CPT 27620 | $1,547.00 | $1,547.00 | $22.22 – $155.52 | 768 |
| Ex sq tumor/face or scalp < 2 cm 21011 CPT 21011 | $899.00 | $899.00 | $79.77 – $819.88 | 768 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | $1,166.00 | $1,166.00 | $14.59 – $121.44 | 768 |
| External chromosome analysis 20-25 cells CPT 88264 | $159.25 | $245.00 | $69.34 – $290.67 | 47 |
| External newborn metabolic screening panel HCPCS S3620 | $123.50 | $190.00 | $36.82 – $190.00 | 39 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $50.70 | $78.00 | $22.07 – $78.00 | 118 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $737.75 | $1,135.00 | $139.29 – $1,135.00 | 47 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $55.90 | $86.00 | $17.37 – $86.00 | 47 |
| Extraction of lens 66920 CPT 66920 | $11,774.72 | not published | $0.96 – $4,938.64 | 86 |
| Eye implant band 40 HCPCS C1784 | $1,141.56 | $1,756.25 | $15.07 – $53.25 | 33 |
| Eye Socket (Orbit) X-ray CPT 70200 | $500.50 | $770.00 | $96.27 – $770.00 | 118 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $1,587.30 | $2,442.00 | $161.52 – $2,442.00 | 118 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $1,550.90 | $2,386.00 | $96.27 – $2,386.00 | 118 |
| F-18 fdg pet diag HCPCS A9552 | $1,768.20 | $1,768.20 | $500.40 – $1,768.20 | 33 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $15,145.00 | $15,145.00 | $1,789.13 – $15,145.00 | 114 |
| F-18 fluciclovine per mci HCPCS A9588 | $27,455.00 | $27,455.00 | $315.82 – $27,455.00 | 115 |
| F-18 sodium fluoride HCPCS A9580 | $1,391.25 | $1,391.25 | $393.72 – $1,391.25 | 33 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $2,321.80 | $3,572.00 | $321.26 – $3,572.00 | 118 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $159.25 | $245.00 | $69.34 – $245.00 | 118 |
| Facial Bones X-ray (complete) CPT 70150 | $424.45 | $653.00 | $96.27 – $653.00 | 118 |
| Factor ix CPT 85250 | $340.60 | $524.00 | $18.45 – $524.00 | 47 |
| Factor viii CPT 85240 | $227.50 | $350.00 | $17.35 – $236.00 | 47 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $40.90 | $40.90 | $0.80 – $3.00 | 104 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $9,722.40 | $9,722.40 | $27.37 – $9,722.40 | 118 |
| Fat/lipids feces qualitative CPT 82705 | $37.70 | $58.00 | $4.95 – $58.00 | 47 |
| Fatty acids nonesterified CPT 82725 | $79.95 | $123.00 | $18.19 – $123.00 | 47 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | $28,233.45 | $28,233.45 | $61.99 – $28,233.45 | 118 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $90.35 | $139.00 | $18.06 – $139.00 | 47 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $16,005.99 | $165.00 | $0.85 – $3,534.34 | 118 |
| Fern test HCPCS Q0114 | $39.65 | $61.00 | $9.55 – $61.00 | 44 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $5,262.00 | $5,262.00 | $1.86 – $5,262.00 | 36 |
| Ferritin CPT 82728 | $603.20 | $175.00 | $13.21 – $175.00 | 118 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $712.85 | $712.85 | $0.35 – $712.85 | 118 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.